Dopamine Nation



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Truth-telling as Prevention


“Let me first explain my role,” I said to Drake, a physician I’d been asked to
assess by our professional well-being committee.
“I’m here to determine whether you might have a mental illness that
adversely impacts your ability to practice medicine, and whether any
reasonable accommodations are necessary for you to do your job. But I hope
you will also see me as a resource beyond today’s evaluation, should you
need mental health treatment or emotional support more broadly.”
“Thanks for that,” he said, looking relaxed.
“I understand you got a DUI?”
DUI, or driving under the influence, is a legal infraction for operating a
vehicle while intoxicated. For drivers twenty-one years or older in the
United States, driving with a blood alcohol concentration (BAC) of 0.08
percent or higher is illegal.
“Yes. More than ten years ago, when I was in medical school.”
“Hmm. I’m confused. Why are you seeing me now? Typically, I’m asked to
evaluate physicians in practice right after they get a DUI.”
“I’m new on faculty here. I reported the DUI on my application form. I
guess they [the well-being committee] just wanted to make sure everything’s
okay.”
“I guess that makes sense,” I said. “Well, tell me your story.”

In 2007, Drake was in his first semester of his first year of medical school.
He’d driven out to the Northeast from California, trading the sunbaked
grasslands of the Pacific Coast for the color-drenched rolling hills of New
England in all their autumnal glory.
He had decided on medicine belatedly, some time after completing his
undergraduate studies in California, where he’d effectively majored in
surfing and spent one semester living in the woods behind campus, “writing
bad poetry.”
After the first exam, some of his med school classmates threw a party at
their house in the country. The plan was for a friend to drive, but at the last
minute, the friend had car trouble, so Drake ended up driving.


“I remember it was a beautiful early fall day in September. The house was
down a country road, not far from where I was living.”
The party turned out to be more fun than Drake expected. It was the first
time he’d let loose since coming to medical school. He started out drinking a
couple of beers, then progressed to Johnnie Walker Blue Label. By 11:30
p.m., when the cops showed up because of a neighbor calling in the noise,
Drake was drunk. So was his friend.
“My friend and I realized we were too drunk to drive. So we stayed at the
house. I slept. The cops and most of the other guests left. I found a couch and
tried to sleep it off. At 2:30 a.m., I got up. I was still a little drunk, but I
didn’t feel impaired. It was a straight shot down one empty country road back
to my house. Two to three miles tops. We went for it.”
As soon as Drake and his friend pulled onto the country road, they saw a
police car waiting on the side of the road. The police pulled up behind them
and started following them, as if they’d been waiting for them all along. They
came to an intersection where there was a light signal hanging from one wire.
It was blowing and twisting in the wind.
“I thought it was flashing yellow my way, and red the other way, but it was
hard to tell with it swinging like that. Also, I was nervous with the cop right
behind me. I went through the intersection slowly, and nothing happened, so I
figured I was right about the flashing yellow, and I kept going. Just one more
intersection, and a left turn to my house. I took the turn, but forgot to put on
my blinker, and that’s when the cop pulled me over.”
The police officer was young, about the same age as Drake.
“He seemed new to the job, almost like he felt bad for pulling me over but
had to do it.”
He gave Drake a roadside sobriety test and Breathalyzed him. He blew
0.10 percent, just over the legal limit. The officer took Drake to the station,
where Drake filled out a bunch of paperwork and learned that his license
was temporarily suspended for driving under the influence. Someone from
the station drove him home.
“The next day, I remembered a rumor that a friend I’d grown up with had
gotten a DUI during his residency in emergency medicine. He was someone I


really respected. He’d been our class president. I gave him a call.”
“ ‘Whatever you do,’ my friend said when I reached him, ‘you cannot get a
DUI on your record, especially as a doctor. Get a lawyer immediately and
they’ll find a way to get it down to a “wet reckless” or get it off completely.
That’s what I did.’ ”
Drake found a local lawyer and paid him $5,000 up front, money he took
out of his student loans.
The lawyer said to him, “They’re going to assign you a court date. Dress
up. Look nice. The judge is going to call you up to the stand and ask you how
you plead, and you’re going to say ‘Not guilty.’ That’s it. That’s all you have
to do. Two words. ‘Not guilty.’ We’ll take it from there.”
On the day of his hearing, Drake dressed up like he was told to. He lived a
few blocks from the courthouse, and as he walked there, he got to thinking.
He thought about his cousin in Nevada who’d been driving while intoxicated
and collided head-on with an eighteen-year-old girl coming the other way.
They both died. People who saw his cousin in a bar just beforehand said he
was drinking like he wanted to die.
“At the courthouse, I saw a bunch of other men about my age. They looked,
you know, less privileged than me. I was thinking they probably didn’t have a
lawyer like I did. I started to feel a little sleazy.”
Once inside the courtroom, waiting to be called, Drake kept running the
plan through his head, just like his lawyer told him: “The judge is going to

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